what is Cannabis(marijuana) Related Disorders and its treatment?

WHAT IS CANNABIS?

                Cannabis (also known as marijuana) is the fourth most commonly used psychoactive drug among adults in the United States, after caffeine, alcohol, and nicotine.

CANNABIS PREPARATIONS:

               Cannabis preparations are obtained from the plant Cannabis sativa which has been used in China, India, and the Middle East for approximately 8,000 years, primarily for its fibers and secondarily for its medicinal properties. The plant occurs in male and female forms. The female plant contains the highest concentrations of more than 60 cannabinoids that are unique to the plant. Delta-9-tetrahydrocannabinol (Δ9- THC) is the cannabinoid that is primarily responsible for the psychoactive effects of cannabis. The most potent forms of cannabis come from the flowering tops of the plants or from the dried, black-brown, resinous exudate from the leaves, which are referred to as hashish or hash. The cannabis plant is usually cut, dried, chopped, and rolled into cigarettes (commonly called “joints”), which are then smoked. The common names for cannabis are marijuana, grass, pot, weed, tea, and Mary Jane.

EPIDEMIOLOGY:

              Prevalence and Recent Trends based on the 2012 National Surveys on Drug Use and Health, an estimated 19 million persons aged 12 years and older (7 percent) had used marijuana in the past month. Of this age group, 2.4 million initiated use within the last year, 57 percent of which initiated use before age 18 years.

DEMOGRAPHIC CORRELATES:

              The rate of the past year and current marijuana use by males was almost twice the rate for females overall among those aged 26 and older. This gap narrows with younger users; at ages 12 to 17, there are no significant differences

CANNABIS USE DISORDER:

              The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes the diagnosis of cannabis use disorder. People who use cannabis daily over weeks to months are most likely to become dependent. The risk of developing dependence is around one in ten for anyone who uses cannabis. The earlier the age of first use, the more often cannabis has been used, and the longer it has been used, the higher the risk of dependence.

CANNABIS INTOXICATION:

              Cannabis intoxication commonly heightens users’ sensitivities to external stimuli, reveals new details, makes colors seem brighter and richer, and subjectively slows the appreciation of time. In high doses, users may experience depersonalization and derealization.

CANNABIS WITHDRAWAL:

               Studies have shown that cessation of use in daily cannabis users results in withdrawal symptoms within 1 to 2 weeks of cessation. Withdrawal symptoms include irritability, cannabis cravings, nervousness, anxiety, insomnia, disturbed or vivid dreaming, decreased appetite, weight loss, depressed mood, restlessness, headache, chills, stomach pain, sweating, and tremors.

CANNABIS-INDUCED PSYCHOTIC DISORDER:

               The cannabis-induced psychotic disorder is diagnosed in the presence of cannabis-induced psychosis. The cannabis-induced psychotic disorder is rare; transient paranoid ideation is more common.

Florid psychosis is somewhat common in countries in which some persons have long-term access to cannabis of particularly high potency.

CANNABIS-INDUCED ANXIETY DISORDER:

              Cannabis-induced anxiety disorder is a common diagnosis for acute cannabis intoxication, which in many persons induces short-lived anxiety states, often provoked by paranoid thoughts. In such circumstances, panic attacks may be induced, based on ill-defined and disorganized fears.

TREATMENT AND REHABILITATION:

             Treatment of cannabis use rests on the same principles as treatment of other substances of abstinence and support. Abstinence can be achieved through direct interventions, such as hospitalization, or careful monitoring on an outpatient basis by the use of urine drug screens, which can detect cannabis for up to 4 weeks after use. Support can be achieved through the use of individual, family, and group psychotherapies. Education should be a cornerstone for both abstinence and support programs. A patient who does not understand the intellectual reasons for addressing a substance problem has little motivation to stop. For some patients, an antianxiety drug may be useful for short-term relief of withdrawal symptoms. For other patients, cannabis use may be related to an underlying depressive disorder that may respond to specific antidepressant treatment

                                       Thank you everyone and stay healthy.